What is lumbago?
In the past, lumbago was regarded as a specific disease and appeared as such in the medical textbooks. However, today it is recognized that lumbago is a symptom rather than a disease and can be caused by a wide range of conditions affecting the lower part of the back. Pain in this region is so common and disabling that lumbago has come to be graded as a disorder in its own right. The term is still widely used and may be conveniently be applied to include the effects of a number the lower back.
The medical profession believes that it is misleading to use the term lumbago for the range of sciatic and neurological (nerve related) problems included under the overall term back pain. One common feature of lumbago is that, in many cases, investigation fails to find a specific cause for the pain.
Since lumbago, or non-specific low back pain, is associated with muscles or ligaments, it is very common and so is responsible for an enormous of the time lost from work. Lumbago is just as liable to affect office workers as those engaged in heavy manual work because of the dangers of poor posture.
What causes lumbago?
The spine (vertebral column) is surrounded by a complex mass of muscles, ligaments and tendons that bind the separate bones (vertebrae) together, supporting them and allowing a range of movement between them. The muscles in the lower back region has an arduous task in keeping the upper part of the body upright. As a result, it is common for the paravertebral muscles (the muscles attached to the spine) to become strained and painful. This sort of lumbago is especially likely if the muscles have be come weakened by disuse, forcing them to work harder to support the spine.
The spine contains many faceted joints between the vertebrae. These are held together by short ligaments that allow limited movements between any pair of adjacent bones. Sometimes, a sudden movement, or the careless lifting of a heavy weight, may allow one or more of the short ligaments to be stretched or even torn.
Occasionally, a bone may be slightly displaced so that the facets of the joints are no longer in the correct alignment. This is called subluxation both ligament strain and the spasm of muscles that accompanies a subluxation may cause lumbago.
Sometimes muscles in the lower back area go into prolonged and excessive tightening or contractions. This called lumbosacral spasm and is another cause of lumbago.
On some occasions a small portion of the synovial membrane (the fluid-secreting lining of the capsule that surrounds a joint) may become nipped between the surface of the facets. This also is thought to be a cause of lumbago.
How is lumbago diagnosed and treated?
The doctor’s first responsibility is to distinguish lumbago from some of the other, serious, causes of low back pain. This includes prolapsed intervertebral disc, where the jelly-like center of the disc bulges or extrudes through the tough outer case, and causes pressure on the spinal nerves.
Other possible causes must be considered including obesity pancrreatitis (inflammation of the pancreas) kidney disorders (such as pyelonephritis), peptic ulcer. Orthopaedic conditions such as spondylolisthesis, and disease that can attack the spine such as cancer and tuberculosis.
A diagnosis of lumbago is not usually made unless all such conditions can be excluded.
Treatment mostly involves self -help measures such as rest and painkillers. However, experts now recommend no more than 48 hours bed rest in most cases.
Exercises to strengthen the back and abdominal muscles are often recommended by the doctor or taught by the therapist to relieve most types of lumbago and to prevent further attacks.
What can I do myself?
Most cases of lumbago respond well to 48-hour bed rest followed by a gentle return to mobility. Sof,t yielding mattresses do not provide enough support. If necessary, put a large board under your mattress or put the mattress on the floor.
A hot bath or hot-water bottles can be helpful in the acute stages. Sometimes ice packs have the same effect. Anti-inflammatory painkillers, such as aspirin or ibuprofen may also help.
When should I see my doctor?
See your doctor if the pain persists for more then a day or two. Do not delay if they are any symptoms of general upset, such as fever or loss of appetite, or any symptoms in other parts of the body.
Is lumbago dangerous?
Pain originating in spinal joints, muscles or ligaments is rarely dangerous.
How can I avoid lumbago?
Here are a few simple rules to bear in mind in order to reduce strain on your back:
* Try to maintain the normal upright posture of the spine, so that the forces are mainly vertical and are taken by the bones rather than the muscles, ligaments and tendons.
* When lifting a heavy weight, maintain an upright spinal posture and bend the knees. The leg muscles the do the lifting.
* Avoid bending your back when pushing heavy objects. Turn around and push against the object with the small of your back.
* If you use a chair at work, ensue that it provides adequate back support and allows you to maintain a good posture.
* Get rid of excess weight and start a regular programme of exercises to strengthen the back and abdominal muscles.
* When sitting, do not slouch.
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